Chronic Pain Management with Neuropathy

Neuropathic pain is a complex chronic pain state that is usually accompanied by tissue injury. With this type of pain, the nerve fibers themselves may be damaged, dysfunctional or injured. These damaged nerve fibers send erroneous signals to other pain centers in your brain. The impact of nerve fiber injury includes a change in nerve function both at the site of injury and areas around the injury.

According to the Neuropathic Pain Network, somewhere between five to twenty-three million people (that’s between 2 to 8 percent of our population) are living with neuropathic pain in the United States. Unfortunately, it is a syndrome that is often under-diagnosed and under-treated.

Some of the symptoms of neuropathic pain including shooting pain, burning pain, tingling, and numbness. An example of neuropathic allodynia—a non-harmful stimulus perceived as painful—is rough clothing rubbing on your skin which you feel as if it were sandpaper; another example would be someone shaking your hand in what is really a gentle grasp but you feel it as crushing or excruciating.

Another striking example of neuropathic pain is called phantom limb syndrome. This occurs when a limb like an arm or a leg has been removed because of illness or injury. The brain still receives (or perceives) pain messages from the nerves that originally carried impulses from the missing limb. These nerves now misfire and cause pain.

As anyone living with neuropathic pain knows the treatment can be frustrating and often ineffective. While acute short-term pain is usually easy to manage and most chronic pain management conditions can be treated effectively, neuropathic pain can be a major treatment challenge for both patients and their healthcare providers. Unfortunately, neuropathic pain often responds poorly to standard pain treatments and occasionally may get worse instead of better over time. For some people, it can lead to serious disability.

The capsaicin patch could be a much needed tool for many people experiencing neuropathic pain symptoms and find that other pain management medications (e.g., opiates or SSRI’s and SNRI’s) are not helping or have too many side effects. Of course medication management is only one component of an effective pain management treatment plan.

I believe that people also need to be developing nonpharmacological interventions as well as learning to better manage the psychological/emotional components of their pain. For those symptoms cognitive behavioral and rational emotive therapeutic interventions give the best outcomes.

To learn more about effective chronic pain management check out my article The Need for Multidisciplinary Chronic Pain Management that you can download for free on our Article page.

If you'd like to receive training for helping people with chronic pain and coexisting disorders, including addiction, I'm very excited to announce we are presenting my Addiction-Free Pain Management® Certification Training in Sacramento on August 5-7, 2010. To learn more about this 3 day 20 hour training and my other upcoming trainings you can check out our Calendar page.

You can learn more about the Addiction-Free Pain Management® System at our website www.addiction-free.com. If you or a loved one is undergoing chronic pain management, especially if you're in recovery or believe you may have a medication or other mental health problem and you want to learn more effective chronic pain management tools, please go to our Publications page and check out my books; especially the Addiction-Free Pain Management® Recovery Guide: Managing Pain and Medication in Recovery. To purchase this book please Click Here.

To read the latest issue of Chronic Pain Solutions Newsletter please Click here. If you want to sign up for the newsletter, please Click here and input your name and email address. You will then recieve an autoresponse email that you need to reply to in order to finalize enrollment.

Positive Chronic Pain Management Outcomes Require Coping with Denial

Two Antidotes for Denial:

1. Peaceful Acceptance and

2. Problem Solving with Authentic Action

Acceptance is a peaceful acknowledgement of the truth. If you can calmly face the problem, acknowledge the truth about what is going on, and accept that it is happening to you, you can then develop a way for handling the situation. The person who has accepted the truth of a serious problem has the ability to honestly affirm to themselves: "I have a serious problem! I am responsible for dealing with it! I'm willing to learn how!"

Problem Solving is a system for finding solutions to your problems. Effective problem solving systems involve identification and clarification of your problems, identifying and projecting the logical consequences of alternatives, deciding which alternative to use, taking action, and evaluating the outcome. By recognizing and accepting the problem and developing an effective problem solving plan, your need to use denial will go down because your ability to manage your problems will go up.

This was the reason I teamed up with Terry Gorski and Jennifer Messier to write the Denial Management Counseling (DMC) for Effective Pain Management Workbook that could be a helpful resource for some of you reading this Blog. I believe that learning to identify and manage denial is a necessary first step for people living with chronic pain who want to learn how to develop and implement an effective pain management plan.

The DMC/Pain Workbook is designed for people who have experienced significant problems related to living with chronic pain, but who honestly don’t believe—or don’t want to believe—that their decisions and behaviors are undermining what could be an effective pain management plan. It can be one important tool to help someone identify and learn to manage their inner saboteur.

To learn more about chronic pain management and denial please check out my article From Denial to Effective Chronic Pain Management that you can download for free on our Article page.

If you'd like to receive training for helping people with chronic pain and coexisting disorders, including addiction, I'm very excited to announce we are presenting my Addiction-Free Pain Management® Certification Training in Sacramento on August 5-7, 2010. To learn more about this and my other upcoming trainings you can check out our Calendar page.

You can learn more about the Addiction-Free Pain Management® System at our website http://www.addiction-free.com/ If you are working with people in chronic pain or are undergoing chronic pain management and have any resistance or denial and want to learn how to develop a plan for helping to identify and manage denial please go to our Publications page and check out my book the Denial Management Counseling for Effective Pain Management Workbook. To purchase this book please Click Here.

To read the latest issue of Chronic Pain Solutions Newsletter please click here. If you want to sign up for the newsletter, please click here and input your name and email address. You will then recieve an autoresponse email that you need to reply to in order to finalize enrollment.

Chronic Pain Management May Lead to Long-Term Opiate Problems

According to researched published in Pain Physician Journal (2006), 90 percent of people in the US receiving treatment for pain management are prescribed opiate medication. Of that number 9 percent to 41 percent had opiate abuse/addiction problems. Unfotunately, this is not the only problem with prolonged use of opiates.

Neuroplasticity (variously referred to as brain plasticity or cortical plasticity or cortical re-mapping) refers to the changes that occur in the organization of the brain as a result of experience. A surprising consequence of neuroplasticity is that the brain activity associated with a given function can move to a different location as a consequence of normal experience or brain damage/recovery.

According to research published in Annals of the New York Academy of Sciences 933:175-184 (2001) titled “Spinal Cord Neuroplasticity following Repeated Opioid Exposure and Its Relation to Pathological Pain;” convincing evidence has accumulated that indicates there are neuroplastic changes within the spinal cord in response to repeated exposure to opioids. Such neuroplastic changes occur at both cellular and intracellular levels. Since so many people living with chronic pain are using opiates these neuroplastic changes need to be better understood.

Learn more about the down side of long-term opiate use in chronic pain management by reading my 2009 News and Research Post titled Long-Term Opioid Use May Increase Sensitivity to Chronic Pain that you can read by going to this link and scrolling down the page to that title.

To learn more about effective chronic pain management please check out my article The Need for Multidisciplinary Chronic Pain Management that you can download for free on our Article page.

If you'd like to receive training for helping people with chronic pain and coexisting disorders, including addiction, I'm very excited to announce we are presenting my Addiction-Free Pain Management® Certification Training in Sacramento on August 5-7, 2010. To learn more about this and my other upcoming trainings you can check out our Calendar page.

You can learn about the Addiction-Free Pain Management® System at our website http://www.addiction-free.com/ If you are working with people undergoing chronic pain management and want to learn how to develop a plan for managing their chronic pain and coexisting psychological disorders; including depression, addiction and other coexisting psychological disorders effectively; please consider my book Managing Pain and Coexisting Disorders: Using the Addiction-Free Pain Management® System. To purchase this book please Click Here.

To read the latest issue of Chronic Pain Solutions Newsletter please click here. If you want to sign up for the newsletter, please click here and input your name and email address. You will then recieve an autoresponse email that you need to reply to in order to finalize enrollment.

To see an online overview of a Web-Based Delivery of Addiction-Free Pain Management® please go to this Link for a free demo.

The Suboxone Controversy

Last month I posted a new article on our website on Suboxone. I'm including a few paragraphs below.

There is a difference of opinions on whether patients should be maintained on Suboxone (buprenorphine) or go through a total detoxification for opiate addiction. A similar debate has been going on for decades about another medication used for opiate addiction treatment—methadone. I would like to propose a third option: using the medication as a transitional treatment intervention with eventual discontinuation.

Unlike methadone physicians are more likely to prescribe Suboxone in their offices for people who are dependent or addicted to opiates such as opiate pain medication, heroin, or methadone. Buprenorphine (the active treatment medication in Suboxone) is a more convenient maintenance medication for opiate addiction because it does not require daily or weekly visits to a clinic. Buprenorphine blocks the effects of other opiates; it reduces or eliminates cravings and prevents withdrawal symptoms such as pain and nausea.

Subutex and Suboxone are the brand names that buprenorphine is being marketed as for the treatment of opiate dependence. Both medications contain the active ingredient buprenorphine hydrochloride, which works to reduce the symptoms of opiate dependence. Subutex contains only buprenorphine hydrochloride which was developed as the initial product.

Please check out this entire article titled Revisiting Suboxone: Maintenance versus Total Detoxification that you can download for free on our Article page.

You can learn about the Addiction-Free Pain Management® System at our website www.addiction-free.com. If you are working with people undergoing chronic pain management and want to learn how to develop a plan for managing their chronic pain and coexisting psychological disorders; including depression, addiction and other coexisting psychological disorders effectively; please consider my book Managing Pain and Coexisting Disorders: Using the Addiction-Free Pain Management® System. To purchase this book please Click Here.

To read the latest issue of Chronic Pain Solutions Newsletter please click here. If you want to sign up for the newsletter, please click here and input your name and email address. You will then recieve an autoresponse email that you need to reply to in order to finalize enrollment.

To see an online overview of Cognit delivering Addiction-Free Pain Management® please go to this Link for a free demo.

To learn about my upcoming trainings you can check out our Calendar page.

Telephone Coaching for Relapse Prevention

People undergoing chronic pain management need all the support they can get. If they also experience some of the common coexisting problems such as addiction or other mental health conditions relapse prevention is crucial. The Addiction-Free Pain Management® (APM) Relapse Prevention telephone coaching may be the missing piece for ultimate success for effective chronic pain management. Our coaching programs are also for anyone in recovery from any addictive disorder and will help people develop essential tools for avoiding future relapse.

Our Relapse Prevention Coaching services are individualized coaching sessions for anyone who is in recovery from an addiction and the use of self-defeating, self-destructive behaviors and wants to learn how to recognize and effectively manage situations that put their recovery at risk. It is especially helpful for individuals who have had relapse episodes, but anyone in recovery will find it useful. We combine the Gorski-CENAPS® relapse prevention methodology with personal empowerment coaching strategies to create a powerful foundation for long-term stable sobriety.

The Relapse Prevention Coaching Programs can assist individuals leaving treatment and support those people who cannot or chose not to go into traditional treatment programs. They are also invaluable for people who have had limited success with outpatient treatment, or for those who want to enhance their current program and learn how to put these powerful relapse prevention tools to work in their lives.

With the assistance and the support of a Certified Coach, clients will experience the seven clinical processes that help them to quickly identify and manage high-risk situations that cause relapse. They will receive expert guidance in setting powerful recovery goals and implementing specific actions plans to facilitate their continued recovery.

The foundation of our Relapse Prevention Coaching Program is the evidence-based work and 35 years experience of Terence T. Gorski's Developmental Model of Recovery. As an Advanced Relapse Prevention Specialist and Director of Training and Consultation for the CENAPS® Corporation, my expertise in denial, relapse prevention and co-existing disorders underlie his biopsychosocial, multidisciplinary approach utilizing an ongoing continuum of care that incorporates strategic, cognitive-behavioral skill building exercises in conjunction with powerful solution-focused and strength-based coaching methodologies.

If people knew they could participate from anywhere using their phone and a computer, and that they could become active participants in their healing by participating in our coaching program, we feel confident that their feelings of helplessness and hopelessness would disappear.

Check out our Coaching Questionnaire which is the first step of deciding if you or someone you know is ready for APM Relapse Prevention Coaching, or call Ellen at 916-575-9961for a confidential interview.

If you want more information on relapse prevention for chronic pain management please go to our website and on the articles page archive click on my article Relpase Prevention and Chronic Pain Management, that you can download for free on our Ariticles page.

To learn more about effective chronic pain management check out my article The Need for Multidisciplinary Chronic Pain Management that you can download for free on our Articles page.

You can learn about the Addiction-Free Pain Management® System at our website http://www.addiction-free.com/ If you are working with people undergoing chronic pain management and want to learn how to develop a plan for managing their chronic pain and coexisting psychological disorders; including depression, addiction and other coexisting psychological disorders effectively; please consider my book Managing Pain and Coexisting Disorders: Using the Addiction-Free Pain Management® System. To purchase this book please Click Here.

To read the latest issue of Chronic Pain Solutions Newsletter please click here. If you want to sign up for the newsletter, please click here and input your name and email address. You will then recieve an autoresponse email that you need to reply to in order to finalize enrollment.

To see an online overview of Cognit delivering Addiction-Free Pain Management® please go to this Link for a free demo.

To learn about my upcoming trainings you can check out our Calendar page.

Check out a Free Demo of Addiction-Free Pain Management®

We now have an overview of the Addiction-Free Pain Management® System Powered by Cognit. To see an online overview of Cognit delivering APM please go to this Link for a free demo.

Cognit is a powerful web-based recovery tool using Terence T. Gorski’s 40 years of expertise in addiction recovery and relapse prevention as well as my 27 years of work with people living with chronic pain management conditions including coexisting psychological problems including addiction.

Cognit provides individuals, treatment centers and other organizations who offer addiction and/or mental health treatment with web-based educational and self-awareness tools. Cognit supports and enhances all stages, as well as modalities, of treatment and recovery for people who suffer from addiction and related mental health issues. The Cognit process combines educational content, self application E-Workbook exercises, session quizzes as well as self-awareness inventories that were developed by Cognit co-founder Wayne Blampied.

The Cognit system acts as a support umbrella from pre-treatment, to the earliest stages of treatment and all the way through late recovery. No matter what course recovery takes, Cognit supports the entire process. The true value of Cognit is in its ability to assist in the treatment process by offering effective, consistent, science-based, easy to use educational content and its ability to assess and quantify a patient’s progress.

You can learn about the Addiction-Free Pain Management® System at our website http://www.addiction-free.com/ If you are working with people undergoing chronic pain management and want to learn how to develop a plan for managing their chronic pain and coexisting psychological disorders; including depression, addiction and other coexisting psychological disorders effectively; please consider my book Managing Pain and Coexisting Disorders: Using the Addiction-Free Pain Management® System. To purchase this book please Click Here.

To read the latest issue of Chronic Pain Solutions Newsletter please click here. If you want to sign up for the newsletter, please click here and input your name and email address. You will then recieve an autoresponse email that you need to reply to in order to finalize enrollment.

To learn about my upcoming trainings you can check out our Calendar page.

Personal Impowerment for Effective Chronic Pain Management

I believe an important part of effective chronic pain management is understanding everything you can about your pain and then learning some effective tools that will allow you to respond in an appropriate way so that you can improve the quality of life. Whenever you experience pain, it is always appropriate to ask: "What is my pain trying to tell me?" Remember, pain is trying to tell you that something is wrong, that you should find out exactly what it is, and find a way to address it—not mask it.

Our pain system is a crucial component of our makeup and essential to our ongoing survival. Could you imagine how bad it could get if we didn’t have pain receptors and kept putting ourselves in situations that could seriously damage our body? Imagine that you’re in the kitchen talking on the phone and you put your hand down on a hot burner. Without pain receptors your first indication that something was wrong would be your flesh burning.

Knowledge is Power

To effectively manage a pain condition it is important that you understand exactly what is going on with your body. When you are in pain you experience both physical and psychological symptoms. To understand the language of pain, you must learn to listen to how the pain echoes and reverberates between the physical, psychological, and social dimensions of your human condition. Pain is truly a total human experience that affects all aspects of human functioning.

Personal empowerment is the best—and only—way out

When you are in pain for a long period of time you can begin feeling victimized by your pain. You hate your pain. You want to escape from your pain and are willing to do anything to obtain relief. Unfortunately, the way out for many people leads to self-defeating behaviors, including abusing pain medication.

To learn more about effective chronic pain management please check out my article The Need for Multidisciplinary Chronic Pain Management that you can download for free on our Article page.

To learn about my upcoming trainings you can check out our Calendar page.

You can learn more about the Addiction-Free Pain Management® System at our website http://www.addiction-free.com/ If you or a loved one is undergoing chronic pain management, especially if you're in recovery or believe you may have a medication or other mental health problem and you want to learn more effective chronic pain management tools, please go to our Publications page and check out my books; especially the Addiction-Free Pain Management® Recovery Guide: Managing Pain and Medication in Recovery. To purchase this book please Click Here.

To read the latest issue of Chronic Pain Solutions Newsletter please Click here. If you want to sign up for the newsletter, please Click here and input your name and email address. You will then recieve an autoresponse email that you need to reply to in order to finalize enrollment.